Clinical Information Systems: Products – October 2017

Sept. 26, 2017

6.1 is the path to clinical transformation

MEDITECH’s 6.1 is a clinically-integrated healthcare solution that meets the needs of large IDNs, small critical access hospitals, and more.

For providers, 6.1 gives universal access to the complete patient story across the continuum. For patients, it means caregivers focus their attention on them, rather than their device.

6.1 supports organizations in the following six ways:

  1. Transformational technology. It changes the way physicians interact with IT, with tools that are similar to using a tablet or smartphone.
  2. It contains content that’s evidence-based and peer-reviewed including hundreds of evidence-based order sets, rounds lists, clinical panels, and specialty templates.
  3. It is specialty-specific. An oncologist’s needs are different from a cardiologist’s needs, which are different from an orthopedic surgeon’s needs, and so on. Get the best practice content for the specialty, embedded in the workflow.
  4. By improving physician productivity. It allows physicians to work with technology that gives the complete patient story.
  5. With minimal training. No four hour training sessions or reading large manuals.
  6. With metrics for high-value healthcare. Meet strategic goals for population health, ACOs/PCMHs, and overall sustainability with a Central Business Office and tools that track clinical and financial progress.
Courtesy of MEDITECH

The standard content and specialty-specific best practices that come with 6.1 and Web Ambulatory are: ambulatory order sets, flowsheets, widgets, HPIs; evidence-based inpatient order sets; care plans; inpatient physician documentation templates; ED order sets, documentation templates, clinical panels; clinical decision support interventions; inpatient clinical panels; ITS procedures across imaging modalities; nursing status boards; ED and inpatient patient lists; assessments; and lab tests, micro procedures, BBK tests and products. MEDITECH

Improving risk-adjustment documentation

The Hierarchical Condition Category (HCC) risk-adjustment model is becoming both increasingly more important and challenging to healthcare organizations as it is progressively being applied to not just Medicare Advantage (MA) plans but also Accountable Care Organizations (ACOs) and Hospital Value-Based Purchasing (HVBP) Programs. With the HCC framework, providers assume greater accountability and risk, and while HCCs are irretrievably tied to revenue, they also provide an opportunity for better patient care management by rewarding higher-quality clinical information.

For accurate HCC coding, providers need to capture the complete diagnostic profile of every patient, including all information that impacts a patient’s evaluation, care, and treatment to ensure appropriate payment. HCCs use a risk-adjustment factor (RAF) score that includes patient diagnoses and demographic information.

HCC capture poses some unique challenges including the following:

  • providers must document that the patient’s conditions were monitored, evaluated, assessed, and treated;
  • the highest disease categories for each patient’s conditions must be documented by the provider;
  • complications or comorbidities and major complications or comorbidities must be properly documented;
  • HCCs must be captured every 12 months for each patient to get MA plan reimbursement;
  • the severity and stage of clinical conditions (e.g., stage IV chronic kidney disease) must be captured because such diagnoses could serve as predictors for future healthcare needs;
  • it is difficult for providers to know or even identify which HCCs they are missing before claims are sent, by which time it is usually too late; and
  • a problem list that includes information from narrative documentation needs to be kept updated.

To successfully adapt to the new risk-adjustment environment, M*Modal provides both frontline assistance to physicians so that HCC opportunities are not missed while documenting, and also a backend, concurrent audit of all documents to catch any HCC gaps before claims submission.

M*Modal provides a comprehensive yet modular solution suite designed for hospital inpatient and outpatient facilities to ensure that documentation accurately reflects the HCC risk scores for the patient population based on reported diagnoses. The HCC solutions are built on M*Modal’s single, EHR-integrated, cloud-based platform that utilizes advanced Natural Language Understanding (NLU) technology to embed clinical intelligence into existing documentation workflows. The NLU technology does the heavy lifting of combing through both EHR and narrative documents to find under-specified, deficient documentation, and HCC opportunities.

HCC solutions to help organizations to improve care quality and financial outcomes include real-time, front-end physician HCC aide, back-end CDI workflow and HCC management, and HCC assessment and planning. M*Modal

Near real-time clinical data surveillance

Micromedex 360 Care Insights offers a platform with customizable solutions that monitor and conduct real-time clinical data surveillance, delivering critical, patient-specific clinical decision support at the point of care. 360 Care Insights allows organizations to get in front of problems for faster intervention and better prevention, supported by evidence-based information. With comprehensive data for fast, informed decisions, organizations will be able to quickly identify at-risk patients, improve outcomes, and reduce unnecessary costs.

360 Care Insights is a single solution that works with the hospital information system. It delivers a clinical intelligence dashboard which aggregates multiple sources of patient-specific data in a centralized place to aid clinicians with their clinical workflow and daily routines.

Pharmacy intervention

Provides prebuilt, pharmacy-specific rules for identifying potentially high-risk patients and intervention candidates.

Infection prevention

Alerts staff of the probability of potential outbreaks, and identifies and reports on patients who meet the National Healthcare Safety Network definition of a hospital-acquired infection.

Truven Health immediate care analysis

Provides near real-time quality surveillance and delivers retrospective daily insight into how patient interventions are affecting quality outcomes.

Integration options
Integrates with most electronic medical record systems. Truven

Increasing collaboration, lowering costs through care management systems

Courtesy of HealthEdge

Data consistently show that 20% of patients account for 80% of healthcare expenditure. Identifying these 20% and providing them with comprehensive preventive care is vital to lowering systemwide costs and keeping patients healthier. But identifying those in need of care, determining which services are most appropriate, and engaging patients in the care process can often become a burden for health plans and providers.

To help solve this problem and make care more collaborative among insurers, providers, and patients, healthcare software company HealthEdge developed HealthRules CareManager, a clinical information system that enables ACOs, health plans, MCOs, PCMHs, Medicare plans, Medicaid plans, TPAs, and pharmacy-related and specialty needs organizations to engage members and patients and manage care in the most efficient ways possible.

Courtesy of HealthEdge

CareManager works across channels, providing coordination for plan administrators while also making real-time updates to the patient record and the user’s work board. Using CareManager, plans can analyze members in a multidimensional way, segmenting them and identifying those to proactively contact for regular exam and immunization reminders, or participation in preventative programs. The system also offers a library of preconfigured evidence-based care pathways, with tools designed to meet regulatory requirements, as well as a secure provider portal for payers and clinicians to request and track authorizations and referrals and communicate across an integrated care team—all of which can also be done securely through a responsive-designed web application.

Implementing a technology such as HealthRules CareManager that helps plans and providers better manage care—without an added administrative burden—is a step toward eliminating gaps in care, promoting healthy behavior, and increasing member quality of life, while saving on claim costs. HealthEdge

Sponsored Recommendations

Enhancing Remote Radiology: How Zero Trust Access Revolutionizes Healthcare Connectivity

This content details how a cloud-enabled zero trust architecture ensures high performance, compliance, and scalability, overcoming the limitations of traditional VPN solutions...

Spotlight on Artificial Intelligence

Unlock the potential of AI in our latest series. Discover how AI is revolutionizing clinical decision support, improving workflow efficiency, and transforming medical documentation...

Beyond the VPN: Zero Trust Access for a Healthcare Hybrid Work Environment

This whitepaper explores how a cloud-enabled zero trust architecture ensures secure, least privileged access to applications, meeting regulatory requirements and enhancing user...

Enhancing Remote Radiology: How Zero Trust Access Revolutionizes Healthcare Connectivity

This content details how a cloud-enabled zero trust architecture ensures high performance, compliance, and scalability, overcoming the limitations of traditional VPN solutions...